Objective: To analyze the association and dose response relationship between physical activity and inflammatory markers in college students, so as to provide a reference for promoting cardiometabolic health in college students. Methods: A cluster random sampling method was used to select 747 college students from two universities in Hefei, Anhui Province and Shangrao, Jiangxi Province from April to May 2019. Physical activity was assessed by using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), and peripheral blood was collected to detect plasma inflammatory factor levels [including hypersensitive C reactive protein (hsCRP), interleukin-10 (IL-10), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)]. The differences between the groups were compared by using the χ 2 test and the Kruskal-Wallis rank sum test, and the association between physical activity and inflammatory markers was analyzed by using the Generalized Linear Model. The dose response relationship between physical activity and inflammatory markers was analyzed using the Restricted Cubic Spline Model. Results: The proportions of low physical activity, moderate physical activity, and high physical activity groups of college students were 15.9%, 53.7% and 30.4%, respectively. The levels of hsCRP, IL-10, IL-1β, IL-6 and TNF-α in the high physical activity group were 0.38(0.21, 1.10)mg/L, 70.74(47.90, 116.43)pg/mL, 1.75(1.21, 2.64)pg/mL, 4.33(2.93, 6.82) pg/mL , 5.27(3.89, 7.30)pg/mL,the levels in the low physical activity group were 0.80(0.31, 1.30)mg/L, 73.88 (47.90, 124.24)pg/mL, 1.88(1.42, 2.81) pg/mL, 4.82 (3.64, 6.67) pg/mL, 5.63 (4.34, 7.62)pg/mL, the levels in the moderate physical activity group were 0.63(0.25, 1.30)mg/L, 89.78(58.21, 127.65)pg/mL, 2.21(1.59, 3.27)pg/mL, 5.15( 3.72 , 7.72)pg/mL, 5.87( 4.63 , 8.00)g/mL, and the differences were statistically significant ( H=10.66, 11.38, 27.79, 14.13, 9.44, P <0.05). After adjusting for variables such as gender, body mass index, smoking, alcohol consumption and health status, the results of Generalized Linear Model showed that compared with the high physical activity group, the low physical activity group ( OR=2.20, 95%CI = 1.46- 3.31) and the moderate physical activity group ( OR=1.65, 95%CI =1.22-2.25) were more likely to have high levels of hsCRP, and the moderate physical activity group was more likely to have high levels of IL-1β ( OR=1.85, 95%CI =1.36-2.51), IL-6 ( OR=1.44, 95%CI =1.06-1.96), and TNF-α ( OR=1.43, 95%CI =1.05-1.94) ( P <0.05). The Restricted Cubic Spline Model showed that there was no linear dose response relationship between the time of moderate to vigorous physical activity weekly and IL-10, IL-6, II-1β, and TNF-α ( P <0.05). Conclusion There is an association between physical activity and inflammation in college students, and moderate to high intensity per week could reduce inflammation levels to promote cardiometabolic health in college students.

PURPOSE: This study aims to investigate the efficacy of novel distraction support (DS) in intramedullary nailing treatment for tibial shaft fracture. METHODS: The random controlled trial included adult patients with tibial shaft fractures who were treated with intramedullary nailing at the trauma center between July 2013 and December 2018. Participants were randomly assigned to either control group (n=43) or DS group (n=42) based on whether DS was used during the operation. All surgical procedures were conducted by a single, experienced surgeon. Parameters such as hospital stay, blood loss, operative time, infection, delayed union, and malalignment were recorded for assessment. Shapiro-Wilk test was used to assess normality, and the F test was adopted to measure variance homogeneity. Continuous variables were presented as mean±standard deviation and compared via independent samples t-tests. Categorical variables are expressed as percentages. The Pearson's Chi-squared or Fisher's exact test was used for categorical variables n (%). Two-sided p<0.05 indicated statistical significance. RESULTS: A total of 85 participants were enrolled in the study. All cases achieved acceptable reduction. The operative time was significantly shorter in the DS group than in control group ((75.3±10.5) min vs. (90.4±15.5) min, p<0.001). Additionally, the DS group showed lesser blood loss ((60.1±27.2) mL vs. (85.4±25.4) mL, p<0.001). No significant differences were observed between the 2 groups in terms of hospital stay ((9.4±2.7) days vs. (10.2±3.1) days, p=0.370), infection (3 (7.1%) vs. 2 (4.7%), p=0.978), delayed union (2 (4.8%) vs. 5 (11.6%), p=0.450), and malalignment (3 (7.1%) vs. 5 (11.6%), p=0.713). CONCLUSION The use of DS in intramedullary nailing surgery is effective. The application of this DS system may represent a valuable addition to future clinical practice.
Humans ; Fracture Fixation, Intramedullary/methods* ; Tibial Fractures/surgery* ; Male ; Female ; Adult ; Middle Aged ; Operative Time ; Length of Stay ; Young Adult ; Osteogenesis, Distraction/methods*

OBJECTIVE: To explore the application effectiveness of multidisciplinary team (MDT) in the diagnosis and treatment of chronic refractory wounds, and to provide new ideas for optimizing the clinical diagnosis and treatment of such diseases. METHODS: A retrospective analysis was performed on the clinical data of patients with chronic refractory wounds who underwent surgery at Peking University Third Hospital from January 2015 to October 2023, and a total of 456 patients, including 290 males and 166 females, with an average age of (49.4±16.9) years. According to whether preoperative MDT discussion was conducted, the patients were divided into MDT discussion group and non-MDT discussion group. The overall implementation process of MDT included: Starting and recording with the medical office, collecting data and discussing the initial MDT, informing the patient of the treatment plan and strictly implementing it, and the change of the condition needs to be discussed again by MDT. The general clinical data, anesthesia risk grade, complications (hypertension, diabetes, coronary heart disease), and the etiology and location of chronic refractory wounds between the two groups were compared. The main observational measurements and outcome indicators of treatment effectiveness included the number of surgeries required to achieve wound healing after admission, the recurrence rate after wound healing, the incidence of perioperative complications (pulmonary infection, severe cardiovascular event, vein thrombus embo-lism, cerebral stroke and delirium, etc.), and patient satisfaction score. RESULTS: There were 189 patients in the MDT discussion group and 267 patients in the non-MDT discussion group. There was no significant statistical difference in the clinical data, such as age, gender, body mass index, American Society of Anesthesiologists, comorbidities, etiology, and location of chronic refractory wounds between the two groups (P>0.05). The average number of surgeries required for wound healing in MDT discussion group and non-MDT discussion group was 2.1±1.1 and 2.8±1.6, respectively, with a statistically significant difference (P < 0.001). This difference was also significant in chronic refractory wounds caused by three etiologies: Diabetic ulcer, infection after trauma or surgery, and non-union after radiotherapy (P < 0.05). The recurrence rate of the patients in the non-MDT discussion group after wound healing was 18.0%, slightly higher than that in the MDT discussion group of 14.3% (P>0.05). In terms of perioperative complications, the non-MDT discussion group also had a higher incidence (3.7% vs. 2.6%), but the difference was not statistically significant (P>0.05). In terms of patient satisfaction, the MDT discussion group scored significantly higher (96.5 vs. 91.1, P=0.028). CONCLUSION The MDT mode can significantly reduce the number of surgeries for patients with chronic refractory wounds, improve the effectiveness of therapy and increase patient satisfaction. It is a recommended model for optimizing the clinical diagnosis and treatment effectiveness of chronic refractory wounds.
Humans ; Patient Care Team ; Retrospective Studies ; Chronic Disease ; Male ; Female ; Middle Aged ; Wound Healing ; Aged ; Adult ; Wounds and Injuries/surgery*

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

OBJECTIVE: To evaluate the impact of critical care warning platform (CWP) on clinical outcomes of patients transferred from internal medical ward to intensive care unit (ICU) based on real-world data. METHODS: A retrospective cohort study was conducted. The patients transferred from internal medical ward to ICU of Zhongda Hospital, Southeast University, between January 2022 and October 2024, were enrolled. They were divided into critical care warning group and conventional treatment group based on whether they were connected to the CWP. The patients in the critical care warning group were connected to the CWP, which collected real-time vital signs and treatment data. The platform automatically calculated severity scores, generated individualized risk assessments, and triggered warning alerts, allowing clinicians to adjust treatment plans accordingly. The patients in the conventional treatment group were not connected to the CWP and relied on conventional clinical judgment and nursing measures for treatment management. Baseline characteristics [gender, age, body mass index (BMI), admission type, severity score of illness, underlying diseases, and disease type at ICU admission], primary clinical outcome (in-hospital mortality), and secondary clinical outcomes [ICU mortality, length of ICU stay, total length of hospital stay, and mechanical ventilation and continuous renal replacement therapy (CRRT) status] were collected. Multivariate Logistic regression was used to analyze the impact of CWP on in-hospital death, and subgroup analyses were performed based on different patient characteristics. RESULTS: A total of 1 281 patients were enrolled, with 768 in the critical care warning group and 513 in the conventional treatment group. Compared with the conventional treatment group, the proportion of patients in the critical care warning group with underlying diseases of diabetes and malignancy and transferred to ICU due to sepsis was lowered, however, there were no statistically significant differences in other baseline characteristics between the two groups. Regarding the primary clinical outcome, the in-hospital mortality in the critical care warning group was significantly lower than that in the conventional treatment group [17.6% (135/768) vs. 25.7% (132/513), P < 0.01]. For secondary clinical outcomes, compared with the conventional treatment group, the patients in the critical care warning group had significantly fewer days of mechanical ventilation within 28 days [days: 2 (1, 6) vs. 2 (1, 8), P < 0.05], significantly shorter length of ICU stay [days: 3 (2, 8) vs. 4 (2, 10), P < 0.01], and significantly lower ICU mortality [15.1% (116/768) vs. 21.4% (110/513), P < 0.01]. Multivariate Logistic regression analysis showed that, after adjusting for age and underlying diseases, the use of CWP was significantly associated with a reduction of in-hospital mortality among patients transferred from internal medical ward to ICU [odds ratio (OR) = 0.670, 95% confidence interval (95%CI) was 0.502-0.894, P = 0.006]. Further subgroup analysis revealed that, among patients transferred to ICU due to sepsis, the use of CWP significantly reduced in-hospital mortality (OR = 0.514, 95%CI was 0.367-0.722, P < 0.001). In patients aged ≥ 70 years old (OR = 0.587, 95%CI was 0.415-0.831, P = 0.003) and those with underlying diseases of malignancy (OR = 0.124, 95%CI was 0.046-0.330, P < 0.001), CWP also showed significant protective effects on in-hospital prognosis. CONCLUSION The use of CWP is significantly associated with a reduction in in-hospital mortality among patients transferred from internal medical ward to ICU, demonstrating its potential in assessing the deterioration of hospitalized patients.
Humans ; Intensive Care Units ; Retrospective Studies ; Hospital Mortality ; Prognosis ; Critical Care ; Male ; Female ; Patient Transfer ; Middle Aged ; Aged ; Cohort Studies

Objective:To investigate the feasibility and clinical efficacy of limited open reduction and transepiphyseal intramedullary kirschner wiring for treatment of irreducible fracture of the distal radius diaphysis-epiphysis junction in older children.Methods:A retrospective study was conducted to analyze the data of 17 children with fracture of the distal radius diaphysis-epiphysis junction who had been admitted to Department of Orthopedics, Children's Hospital of Nanjing Medical University from January 2018 to December 2019. All were male. Ten fractures were on the left side and 7 on the right side, all caused by indirect violent falls. The time from injury to operation was (3.1±0.8) d. After a limited incision, about 2 to 4 cm in length, was made with the fracture ends as the center, a single Kirschner wire was used for transepiphyseal and intramedullary fixation. Postoperative imaging results, incisions, forearm soft tissue, and complications were recorded. The forearm function was evaluated at 24 months after operation by the grading system proposed by Price et al.Results:All the 17 patients were followed up for (25.8±2.3) months. In all patients, operation time was 25 (20, 50) min, incision length (2.4±0.6) cm, postoperative angular deformity of the radius 0° (0°, 0°), and postoperative displacement of the radius (1.5±1.1) mm. Incisions healed well 2 weeks after operation with no vascular or neurological complications. Skin irritation of Kirschner wire appeared in 1 case. Fractures healed after 5.0 (4.0, 5.5) weeks. The forearm function evaluated by the Price grading at 24 months after operation was excellent in 15 cases and good in 2 cases.Conclusion:Limited open reduction and transepiphyseal intramedullary kirschner wiring is effective for treatment of irreducible fracture of the distal radius diaphysis-epiphysis junction in older children.

Radiation-induced heart disease (RIHD) is a common complication of radiotherapy and one of the main causes of non-cancer death in patients with thoracic malignant tumors, which seriously affects the clinical outcome and quality of life of patients. PET imaging is able to assess myocardial perfusion, abnormal myocardial metabolic, cardiac sympathetic disorders, myocardial fibrosis and inflammation, and is of great value in the early diagnosis and detection of RIHD. This article reviews the progress of PET imaging in the early detection of RIHD.

Objective: To describe the association of different sleep characteristics and cardiometabolic risk among college students, so as to provide reference for health promotion of college students. Methods: By random cluster sampling method, a questionnaire survey and physical examination including blood pressure, waist circumference and blood lipid indicators, which were conducted in April and May of 2019 among a total of 1 179 college students from the first grade in two universities in Hefei City of Anhui Province and Shangrao City of Jiangxi Province. A total of 729 college students with valid questionnaires were included into analysis. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used to investigate sleep behavior, and the Morning And Evening Questionnaire-5 (MEQ-5) was used to investigate sleep characteristics. The cardiometabolic risk score was derived using the sum of the standardized sex specific Z scores of waist circumference, mean arterial pressure, HDL cholesterol (multiplied by -1), triglycerides, and insulin resistance index. The rank sum tests were used to compare differences in cardiometabolic risk scores across demographic characteristics. Generalized linear models were used to compare the association of different sleep characteristics with cardiometabolic risk scores among college students. Results: The average cardiovascular metabolic risk score of college students was -0.32(-2.03, 1.58). There were statistically significant differences in cardiovascular metabolic risk scores among college students in variables such as smoking, health status, and physical activity levels ( t/F=-3.41, 12.88, 51.07, P <0.01). The results of the generalized linear model showed that nighttime preference ( B=1.89, 95%CI =1.02-3.49), insomnia symptoms ( B=3.25, 95%CI =1.79-5.90), and short or long sleep duration ( B=1.92, 95%CI =1.21-3.05) were positively correlated with the cardiovascular metabolic risk score of college students ( P <0.05). Conclusions Poor sleep patterns among college students are positively correlated with the risk of cardiovascular metabolism. The sleep behavior of college students should be actively changed to reduce the risk of cardiovascular disease.

Objective: To explore the longitudinal correlation between smartphone multitasking and depressive symptoms, so as to provide an evidence based basis for promoting the mental health of college students. Methods: A total of 967 college students were recruited from one university in Taiyuan, Chongqing, and Shenzhen cities, China, by using multi stage randomized cluster sampling from October to December 2021 at baseline, and a follow up survey was conducted in May 2022. Smartphone multitasking behaviors were assessed by means of the Assessment of Smartphone Multitasking for Adolescents (ASMA), and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) among college students. Chi square tests were performed to compare the differences in depressive symptoms between different groups of demographic characteristics, and binary Logistic regression models were employed to analyze the associations between smartphone multitasking and depressive symptoms among college students. Results: The rates of depressive symptoms among college students at baseline and follow up were 35.2% and 42.3%, respectively. Compared to the low level smartphone multitasking index group at baseline, the moderate and high level groups were more likely to experience depressive symptoms at baseline (moderate level group: OR=1.74, 95%CI =1.22-2.50, high level group: OR=2.77, 95%CI =1.94-3.95) and followup (moderate level group: OR=1.41, 95%CI =1.01-1.95, high level group: OR=1.64, 95%CI =1.17-2.29) ( P <0.05). In addition, compared to the persistently low smartphone multitasking index, increased risk of depressive symptoms was associated with maintaining a moderate to high ( OR=2.94, 95%CI =1.83-4.71), and a higher ( OR=2.07, 95%CI =1.31-3.27) or lower smartphone multitasking index ( OR=2.02, 95%CI =1.27-3.19) ( P <0.05). Moreover, higher smartphone multitasking index scores were positively associated with the risk of new-onset depressive symptoms at follow up ( OR=1.87, 95%CI=1.07-3.27, P <0.05). Conclusions Smartphone multitasking behaviors are find to be associated with an increased risk of depressive symptoms in college students. There is a need to reduce smartphone multitasking in order to decrease depressive symptoms and promote students mental health.

Helicobacter Pylori(Hp)is a spiral bacterium that colonized on the surface of gastric muco-sal epithelium.It is the main cause of gastrointestinal diseases because human is the only natural host and can survive in gastric acid.In recent years,relevant clinical studies have shown that Hp infection is closely related to hematological diseases such as allergic purpura(HSP),immune thrombocytopenic purpura(ITP),iron de-ficiency anemia(IDA),megaloblastic anemia(MA),lymphoma,leukemia and so on.Therefore,for Hp infec-tion,early diagnosis and treatment are of great significance for improving the efficacy of hematological diseases.